Self Employed Individuals Health Insurance
Consider a self-employed individual choosing a health plan from the health insurance marketplace without subsidy eligibility. They might select a silver plan costing about a thousand dollars monthly, thinking it covers in-network doctor visits with a reasonable copay. However, a visit to the doctor may reveal a $200 charge because the deductible was not met. […]
Profits in Insurance Industry Are Booming
Profits in the insurance industry are booming. UnitedHealthcare’s operating profit margin was about 5.8% on revenues of $281.4 billion in 2023. Insured individuals not only pay high premiums, but they also face deductibles, copays, and unexpected bills. Insurers exploit the system by enrolling primarily young, healthy individuals, and they manipulate costs, largely enabled by policies […]
Eligibility for Health Savings Accounts
I received many calls involving HSAs. A Health Savings Account (HSA) is a tax-advantaged savings account that allows you to set aside money to pay for qualified medical expenses such as deductibles, copayments, coinsurance, acupuncture, ambulance costs, doctor’s visits, hearing aids, prescription drugs, psychological therapy, psychiatric care, and qualified long-term care services. To be eligible […]
How to Challenge a Billing Error
One of my clients reported a billing error to me and we challenged the insurance carrier and the medical provider. You need to be aware of your right to challenge a bill. We recently decreased a bill from $4,500 down to $100. Please call me. Remember, I’m here to help you. Thank you. https://vimeo.com/1117099614?share=copy
Was Your Health Service Supposed to be Free?
Have you received a medical bill or are you being charged a copayment in the past year for a service you thought should have been free or covered by your insurance carrier? If you receive a bill for a health service you thought was free or should have been covered by your health insurance carrier, […]
Didn’t Schedule the Medical Procedure Within the Pre Authorization Period?
I hope you’re having a fabulous day today. A coverage denial may say the needed care was not provided as a result of not scheduling the services needed within the time period you were originally preauthorized by your insurance carrier. What they do is they send in that you might need pre-authorization, and they give […]
How the ACA Works for Claim Denials
The Affordable Care Act (ACA) granted people the right to appeal decisions made by their health insurers regardless of their insurance type or state of residence. The law also established rules for how insurance companies should handle initial appeals and allows insurers to request a reconsideration of decisions to deny payment. If an insurer upholds […]
Are Insurers Deliberately Denying Claims
Insurers are motivated to avoid paying for care. Many insurers appear to be utilizing increasingly aggressive tactics to do so, deploying technology and applying pressure to company physicians to scrutinize services recommended by patients’ physicians, and often to deny coverage, leaving patients with unexpected bills or delays in care. You need care, and if you’re […]
What Service Do Private Insurance Companies Provide
Hello my friends. What service do private insurers provide in return for the fees they collect? Again, what service do private insurers provide in return for the fees that they collect? You may not realize the extent to which the insurance companies are exposing themselves to the delay and deny strategies. Private insurance is often […]
What Increases Medical Care Costs
The lack of health coverage produces negative consequences. For instance, an individual avoiding upfront medical costs might end up in the emergency room where treatment is much more expensive. This not only increases healthcare costs for everyone but also places a heavier load on public resources and spreads illness. Make sure you have a good […]